Controversy Surrounding ‘Gender-Affirming’ Breast Removal Surgeries for Young Girls
In recent years, there has been a growing debate surrounding the practice of ‘gender-affirming’ breast removal surgeries for young girls with gender dysmorphia. This controversial procedure, also known as “top surgery,” aims to create a more masculine-looking chest for individuals who identify as male. However, the ethical implications and potential long-term consequences of these surgeries have sparked concerns among medical professionals, policymakers, and the general public.
The Manhattan Institute recently released an analysis revealing that since 2017, hundreds of females aged 12 and younger have undergone double mastectomies as part of gender-affirming treatment. According to Leor Sapir, a fellow at the Manhattan Institute, between 5,288 to 6,294 double mastectomies were performed on girls under the age of 18 during the period of 2017 to 2023. Shockingly, 50 to 179 of these girls were just 12 years old or younger at the time of the surgery.
The Data Analysis
The analysis conducted by the Manhattan Institute was based on an “all-payer national insurance database,” which included patients previously diagnosed with gender dysphoria and had the procedure covered by insurance. However, the actual numbers may be higher as the researchers did not account for patients who paid for the surgery out-of-pocket without submitting an insurance claim. The cost of ‘top surgery’ can be relatively affordable, with some procedures costing as low as $3,000, making it accessible to many middle-class families.
Contrastingly, a study led by Vanderbilt University School of Medicine in 2019 found that only 489 top surgeries were performed on adolescents that year. Similarly, a study from Columbia University College of Physicians and Surgeons and the Department of Obstetrics and Gynecology at the University of Southern California reported that 3,678 minors underwent gender-affirming surgery. These discrepancies in data highlight the need for further research and transparency in reporting.
Ethical Concerns
The controversial nature of gender-affirming surgeries for minors has raised ethical concerns among psychologists and medical professionals. Dr. Jonathan Alpert, a Manhattan-based psychotherapist, expressed reservations about the practice, stating, “Taking a scalpel to a psychological disorder is of deep concern to me, especially when it comes to minors.” He emphasized the importance of exploring and challenging a child’s evolving thoughts about gender identity, rather than rushing into surgical interventions.
Psychologists caution that affirming care and treatment may inadvertently reinforce unhealthy behaviors or thoughts in patients seeking validation. While it is normal for young individuals to question their gender identity, experts warn against hasty decisions that could have long-term psychological consequences. The potential risks of depression, anxiety, and substance abuse associated with gender-affirming surgeries underscore the need for a cautious and comprehensive approach to treatment.
Medical Perspectives
Dr. Marc Siegel, a senior medical analyst for Fox News and clinical professor of medicine at NYU Langone Medical Center, echoes concerns about the risks of gender-affirming surgeries for minors. He advocates for a conservative approach that prioritizes psychotherapy and exploration of gender identity without immediate surgical interventions. Dr. Siegel warns of the potential long-term effects of puberty-blocking drugs on bone health, fertility, and mental well-being, emphasizing the need for thorough evaluation and consideration before proceeding with surgical procedures.
The American Academy of Pediatrics (AAP) has reaffirmed its support for gender-affirming care for transgender youth, highlighting the importance of ongoing research and data analysis to inform clinical practice. However, the American College of Pediatricians (ACP) and other allied groups have expressed skepticism about current treatment protocols for children and adolescents with gender dysphoria, calling for a reevaluation of existing policies and practices.
Policy Implications
The Biden administration’s recent stance against gender-affirming surgery for transgender minors reflects a shift in policy towards limiting surgical interventions to adults. While supporting gender-affirming care for minors, the administration emphasizes the role of parents, families, and healthcare providers in making informed decisions about treatment options. The debate over the ethics and appropriateness of gender-affirming surgeries for minors underscores the complexity of balancing individual autonomy with medical ethics and societal norms.
In conclusion, the controversy surrounding ‘gender-affirming’ breast removal surgeries for young girls highlights the need for continued research, ethical reflection, and comprehensive care for individuals with gender dysphoria. As medical professionals, policymakers, and advocates grapple with these complex issues, it is crucial to prioritize the well-being and autonomy of young patients while considering the long-term consequences of surgical interventions. Ultimately, a balanced and evidence-based approach to gender-affirming care is essential to ensure the best outcomes for all individuals seeking treatment for gender dysphoria.
